The purpose of the study was to examine the impact of implementing a creative art activity in a problem-based learning (PBL) course on occupational therapy (OT) students and their tutors. A qualitative-ethnographic study was conducted during 2016-2017. In one meeting of a PBL course, 126 first year OT undergraduate students were asked to create a collage reflecting the case study they chose, followed by a discussion of their experience. Thirty-four students and nine tutors participated in the study. Qualitative analysis was conducted using focus groups, semi-structured interviews, open questionnaires and observations. Findings of the qualitative analysis revealed four main categories: attachment to the client, change in the meeting's atmosphere, developing learning skills, and a creative art activity as a learning, treating and tutoring tool. Implementation of a creative art activity in a PBL course provided enrichment for students in the form of a learning and treatment tool and for tutors in the form of an instruction tool. This study sheds new light on active learning and teaching, and offers some important insights regarding the use of creative art activities in higher education.